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Can we make placebo effect work for us "on-demand"?

Image credit: https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/psb.344; https://en.wikipedia.org/wiki/File:Cebocap.jpg#file

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Povilas S
Povilas S Dec 29, 2020
4
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Making use of classical conditioning

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Povilas S
Povilas S Dec 29, 2020

[1]Rosenberg, Robin; Kosslyn, Stephen (2010). Abnormal Psychology. Worth Publishers. p. 176. ISBN 978-1-4292-6356-6.

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Povilas S
Povilas S Dec 31, 2020

[1]Durand VM, Barlow D (2009). Abnormal psychology: an integrative approach. Belmont, CA: Wadsworth Cengage Learning. pp. 334. ISBN 978-0-495-09556-9.

Blind chance

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Povilas S
Povilas S Dec 31, 2020
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Manel Lladó Santaeularia
Manel Lladó Santaeularia24 days ago
Okay, the method is interesting, but I wonder what is the purpose of that apart from researching the placebo effect? I mean, if a person has a disease and needs a treatment, it would not be ethical to give them a placebo when you can give them the proper treatment, especially if you don't know yet whether they have the same effect. It would not make sense in a practical setting and would not be about "making the placebo effect work for us", unless I am missing something.

The only case where I can see this as useful are situations like chronic pain where, you have a person who needs chronic medication (which will have its negative side effects). In that case, having a similar effect from placebo, you could avoid those effects.
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Povilas S
Povilas S23 days ago
Manel Lladó Santaeularia If you are talking about this particular contribution, I was directing it more towards a personal use in a home-like setting. In fact generally, when starting this session I more had that kind of use in mind - how can people like you and me make use of it by "tricking themselves"?

Good novel ideas can of course contribute to better placebo use in clinical settings also. But the session is not about how can we make placebo effect work for us, because it's already been used in clinical settings for a long time and it is proved to work. It's more about how can we make it work "on-demand", it's about the deception vs knowing aspect. Placebos mostly work because of the deception element. Can we somehow bypass this and simplify the process?

Now about usefulness/ethics. Placebos generally don't treat the disease itself, they mostly affect subjectively perceived symptoms like pain, sleep quality, nausea, etc. One exception to this, that I know of, is Parkinson's disease, where placebos improve patient's motor functions also (an objective benefit), there might be more such cases that are not yet discovered.

But let's face it - arguably the majority of commonly used medications, don't treat the cause of the disease either, they alleviate the symptoms, that's it. So in those cases, there's not much difference what to use, as long as it helps and placebos have the benefit of not causing harmful side effects.

So if a person is taking sleeping pills or painkillers at home, it would be helpful if they could get the same effect by using something pharmacologically inert. Or at least they could lower the consumption of pharmacologically active drugs this way, if not fully replace them. That's why some doctors keep prescribing placebos to their patients even though it's not very ethical.
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Manel Lladó Santaeularia
Manel Lladó Santaeularia22 days ago
Povilas S Okay, I see your point. However, most drugs work better than placebo, otherwise they wouldn't be approved for clinical use. The fact that you can se an improvement when using placebo, compared to not treating, doesn't mean placebo is as good as the treatment.

Thus the question becomes: Would you willingly take a pill that you don't know if it will do 100% effect or 15% effect? Or would you rather take the one that has 100% effect? I believe this is very disease/symptom dependent, but I don't see how you could fully replace a pharmacologically active drug in that way.

If we talk about withdrawal symptoms (class E adverse reactions) then I would definitely think that could be useful in this particular case.

Self-administered placebo

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Shubhankar Kulkarni
Shubhankar Kulkarni Jan 06, 2021

[1]Arthur K. Shapiro, Valerie Mike, Harvey Barten, Elaine Shapiro, Study of the placebo effect with a self-administered placebo test, Comprehensive Psychiatry, Volume 14, Issue 6, 1973, Pages 535-548, ISSN 0010-440X, https://doi.org/10.1016/0010-440X(73)90039-4. (http://www.sciencedirect.com/science/article/pii/0010440X73900394)

[2]Darragh M, Yow B, Kieser A, Booth RJ, Kydd RR, Consedine NS. A take-home placebo treatment can reduce stress, anxiety and symptoms of depression in a non-patient population. Aust N Z J Psychiatry. 2016 Sep;50(9):858-65. doi: 10.1177/0004867415621390. Epub 2015 Dec 16. PMID: 26681262.

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Povilas S
Povilas S2 months ago
As I understand the participants in both of the studies (or at least in the second one) didn't know that they are getting placebos? But what you are suggesting is that a person would know this and would choose between two apparently different types of placebos (presented in a different way, but still knowing that they are essentially the same)? And that the self-assessment of the effects of apparently different placebos would be an important part of this?
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Shubhankar Kulkarni
Shubhankar Kulkarni2 months ago
Povilas S The participants in both the studies did not know they were taking placebos. Yes, I am suggesting exactly that. The self-assessment will be an important part of this. I am thinking of updating my suggestion as I am writing this reply to you. I don't think anyone has used placebo the way I suggest. I don't know whether it will work. But here is why I think it might work -

How does placebo work? - We know something is good for us/ our body. We take it believing that it will improve our status. Just the thought that something will be beneficial causes an additional or a fast improvement, which is over and above that caused by the thing (medication, therapy) that we administer. This is when we did not know much about the placebo effect.

Now we know how placebo works. We know that placebo can be beneficial to us. Placebo is a good thing. So, instead of the medication, we may be able to use the placebo as the thing that we administer. Since we now believe that the placebo is beneficial, the placebo might in turn create a placebo effect. Does any of this make sense?

Moreover, since the person knows it is a placebo, we do not need a third party for blinding. However, I think the self-assessments are necessary for three reasons - 1. By doing the assessments, you put some work into the therapy. You invest in it. This creates an interest in your treatment, which in turn causes a placebo effect. The rewards that you expect are always proportional to your investment. As an example, here is an article that says that costly placebos work better than cheap ones (https://www.sciencedaily.com/releases/2008/03/080304173339.htm). When you pay, you invest in your treatment. This causes a greater improvement in your status. 2. You can track your improvement. You can set a goal and know when you have reached it. You can stop the treatment then. 3. You get to know more about the thing you are suffering from. You can avoid things that cause it in the future.
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Povilas S
Povilas Sa month ago
Shubhankar Kulkarni I agree with the investment part. In the first part, you seem to be talking (more or less) about open-label placebo (OLP). When the person knows that he/she is receiving a placebo and is usually explained that this should work because of the placebo effect. This approach is getting popular recently and there are more and more studies researching OLP treatment. But they are still controversial for now and more research will have to be done before they can get established as legit treatment. Some articles presented evidence that OLPs work just as well as DPs (deceptive placebos). However, this is doubtful, because the placebo effect has a lot to do with expectations and expectations are higher when you think you are receiving the real thing.

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